Stage 2 Sisters Club

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  • Tpralph
    Tpralph Member Posts: 281
    edited September 2017

    thank you special K. I feel better about having the ALND now. guess it is for the best. the surgeon wanted to do it before chemo but was going to make me wait two months and the oncologist wanted to get the ball rolling on the chemo a month out of surgery. 

    hopefully waiting wasn't the wrong choice..... We will see. 

  • TabzIsMyAngel
    TabzIsMyAngel Member Posts: 41
    edited October 2017

    Hi all. New here and feeling a bit overwhelmed. Stage IIA, hormone receptor negative, HER2-positive (3+).

    Immediately following a nasty break up in mid-July I had a biopsy of micro-calcifications that were found on my mammogram. Received my results ( invasive ductal carcinoma) 2 days before embarking on a move from MI to NY to return to my hometown to be near family. It took me a few weeks to get my insurance changed to the new state, then waiting to get in with my new primary care to get a referral to an oncologist. So any further assessment was delayed 2 months.

    Had my right side lumpectomy (2.2cm tumor) and sentinel node dissection (thankfully negative!), along with left side chemo port insertion 2 1/2 weeks ago. Things apparently went badly during the insertion of the cath & I was bleeding out heavily, so had to stay an extra night in the hospital with a heavy compression dressing. Surgeon is hoping the chemo port will function properly, or else he'll have to insert another on my right side. But my oncologist says that's not an option because after I finish chemo I'll be receiving radiation so she doesn't want the port on that side.

    I'm dreading the chemo (a full year) more than I did the surgery. I want to remain positive because I know that's a huge part of the battle, but it's difficult. I'm worried about the side effects and hope they won't be as bad as I'm anticipating. I'm already planning to attend a Look Better, Feel Better workshop on Monday, and start my chemo next Wednesday or Thursday. My local cancer treatment center also offers free Reiki, massage therapy, and monthly support group meetings and I plan to take advantage of all of those, plus hopefully find a yoga class as well. I guess I'm most scared of how I'm going to deal with this because I live alone, so I don't have emotional & household support available 24/7. Even before diagnosis I'd had many days when I just don't have the energy or ambition to do anything and find it hard to get out of bed in the mornings. Knowing it's likely to get worse due to chemo is frightening. Then to top it all off, I'm unemployed. Not having much luck finding a job and not knowing how chemo might affect my ability to work is just one more thing to worry about. I guess I really just need to get out of my head. I'm hoping the complementary therapies & support meetings will help me to keep my outlook positive.

  • ruthbru
    ruthbru Member Posts: 47,698
    edited October 2017

    Hi Tabzls, I am so sorry that you are in such a tough situation with all sorts of hard changes going on all at once. I imagine that you are getting a certain number of rounds of chemo for several months (4 rounds of AC, and taxol for maybe 12 weeks.....something like that?) and doing the Herceptin for a year (to take care of the HER2 component). Everyone reacts differently to chemo (I felt like I had a mild case of the flu, but worked throughout). When you are at the stage of Herceptin alone, then most people feel really pretty okay. I would say that, although it is no fun, for most people chemo isn't as bad as they envision it is going to be. I'm glad you are going to the Look Good workshop & taking advantage of the support therapies offered by your treatment center. Getting some sort of exercise (including walking) is one of the best things you can do for yourself physically AND mentally and, strangely, will give you more energy as well/

    I think getting the diagnosis and making all the treatment decisions is the most awful part; once you get started, then you can start crossing off the days until you are DONE!

    Hang in there and let us know how you are doing. Heart


  • PauletteK
    PauletteK Member Posts: 1,279
    edited October 2017

    Hi tab - sorry that you are in such a hard place, first don’t over thinking, one day at a time. Ruth said that right, everyone responds to chemo differently some have minimal and some have a hard time. I had AC + taxol, AC wasn’t too bad for me, I lost some weight due to lose appetite, fatigue is another problem for me. Now I’m on taxol, beside fatigue I worried about neuropathy, rashes and joint pains. You might want to have friends check in with you all the time, this website is good for information and supports. All of us are going through the same journey so we understand each other

  • Molly50
    Molly50 Member Posts: 3,008
    edited October 2017

    Welcome Tab. I am sorry you are dealing with cancer on top of big life changes. I hope your family and friends will be your support team but you also have us. Hang in there.

  • TabzIsMyAngel
    TabzIsMyAngel Member Posts: 41
    edited October 2017

    Thanx Ruth & Paulette. Being alone allows too much thinking time, but reading thru various threads here helps calm my worries & keeps me hoping for the best.

    My chemo schedule is as follows: 4 cycles of A/C every 21 days. Followed by 12 weeks of Paclitaxel & Herceptin, then continuing Herceptin to finish out a full 52 week course of treatment. I'll also be having radiation either after or near the end of the full chemo cycle.

    I've already been shopping online for a couple cute wigs (@ 123Wigs with a 20% off first purchase offer), but have just put them on my wishlist for now until after the LG/FB workshop in case I learn there of a local free/low-cost option.

    I don't really exercise at all, even though I know I should and my main excuse being I just don't have the energy, even while knowing doing so will eventually give me more energy - LOL. But this morning I did do a few squats & arm exercises with small hand weights & went for a 2-mile walk. I'm going to have to force myself to exercise because I read that women with low muscle mass suffer more severe side effects from chemo,and even though I'm slender, I'm terribly out of shape & don't have the physical strength I know I should have. Wish I'd known that little fact a few months ago so I could get a head start on it, but a few short months ago cancer was nowhere on my radar.

    I'm taking my inspiration (and my screen name) from my former Maine Coon cat Tabitha. At the age of 12 I discovered a lump on her belly. Had surgery done & the vet said it was mammary cancer. He said she technically never should have developed it since I got her spayed before she ever went into heat so never had any estrogen flowing through her system. But he said the margins were very clean and he was certain he'd gotten it all. She lived to be 19 1/2 yrs old, when I finally had to send her to the Rainbow Bridge February of last year. So I know she's watching over me & will see me through this. I'll be taking her picture & a little stuffed toy that looks just like her with me to my chemo sessions.

    Tammy

  • PauletteK
    PauletteK Member Posts: 1,279
    edited October 2017

    Tammy - I do my walk on good days, however with the bad air quality in Northern California I can’t walk outside. You should do more stretching since you finished your surgery. Possible ask your MO for physical therapy because you have lymph node removal. I found PT really helps me, I’m still working with her now.

    I’m going to have my taxol #5 tomorrow, need prayers!!!

  • TabzIsMyAngel
    TabzIsMyAngel Member Posts: 41
    edited October 2017

    Yes, my walking time is limited.... I live in northern NY, barely south of the Canadian border. So once the really cold weather & winter hits, walking outside won't be an option. And being a very rural area, there are no malls or indoor tracks available.

  • NisaVilla
    NisaVilla Member Posts: 505
    edited October 2017
    Tab - I am sorry you had to join us but welcome to the best BC forum. This place has lots of knowledge, love and support. I echo everything others have shared and, in my experience, exercising in the form of brisk-walking was and still is a great addition to my treatment regimen. And we are here to remind you that you, like us, will get through this!

    Paulette - Good luck tomorrow.

    Love to all, Nisa 🌷
  • Tpralph
    Tpralph Member Posts: 281
    edited October 2017
    Hi tab. I'm in Canada Ontario so I know what u r talking about with the cold. I go anyhow. We have a dog and he needs his walk so it forces me to go.there have only been a couple of days that I didn't go due to pain from taxol and neulasta. If u can afford it get a treadmill or used one if you won't go outside. Some food up and can fit under a bed. We r here for u and welcome to our little stage two club
  • OCDAmy
    OCDAmy Member Posts: 289
    edited October 2017

    Hello all. I am also stage 2 and interested in talking and sharing with others. I was diagnosed in February two months after my youngest graduated from college. They tried neo adjuvant endocrine therapy for 4 months to try and shrink my tumor but that didn't do much so I had a BMX with expandersin July and now I'm on 4 cycles of TC with the last one two weeks from today and then on to radiation. Most days I feel pretty positive but then I get so scared that my cancer is more advanced and that none of this will work. I'm ready to get off this crazy ride and get back to the "life after the kids are gone" we had envisioned.

  • ruthbru
    ruthbru Member Posts: 47,698
    edited October 2017

    Welcome OCD. You just do what you can (have to do) while in treatment and then you have to leave it to Fate/God/Luck. Easier said than done, I know!!!! But when you can start doing fun/interesting/engrossing things.....really living your life again, and then you won't have as much time to think scary thoughts and they will slowly recede.

  • PauletteK
    PauletteK Member Posts: 1,279
    edited October 2017

    Hey Amy, you found me here also. I was thinking how to put my old life back all the time, I know it isn’t going to be easy, while I’m doing my chemo, im working with PT make sure my arm is not swelling.

  • runor
    runor Member Posts: 1,615
    edited October 2017

    Hello Tabismy, sorry you are here. If I am correct you are moving (or have moved) somewhere where you have no support system around you. Please ask at the hospital where you will be treated if there is any sort of volunteer organization that looks in on cancer patients who have no family support. I do not know how I would have made it through without the help and support of my family and friends. You might need someone to pick up your mail, or pick up prescriptions if you are too ill to leave the house. I do not know if such an organization exists, but ask and see what kind of support is available through your community or perhaps local church groups.

    Also, and this is just my personal opinion, the need to 'be positive' is just one more burning coal we heap on our heads at the worst possible time. What is there to be positive about? You have cancer! You have lots of miserable stuff to get through! This throws your mortality right in your face and will for a long time. So instead of 'being positive' you can be informed. Be pro-active. Be your own best friend. Be hopeful. Be dedicated to going the distance. Be present for the little things everyday. Be proud of yourself when you make it through tough ordeals. These are all things you can do even when you don't feel positive! I think getting up and showing up to a dreaded appointment is an accomplishment to crow about and it has nothing at all to do with positive. It has to do with being scared to death and doing it anyway. Courage and grit are much more helpful, in my opinion, than positive. So if you can't feel positive, don't. You will carry on anyway and that is what matters.

    Good luck to you. Check in here often. You will learn a lot here. Everyone here supports you and all of us women who share this walk.

  • bravepoint
    bravepoint Member Posts: 232
    edited October 2017

    tab - I live in Ontario. Canada very close to the US border and Ogdensberg, NY. It gets cold here but I bundle in my snow pants and walk every day anyways. My dogs need it and so do I to stay sane. It actually alos helped loosened up my achiness from Taxol chemo last winter.

    My chemo regime was pretty similar to yours except the AC was spread over 3 months. It hit me hard. The Taxol weekly is a lower dose so it was easier on me.

    Good luck to you! You can do this!

  • ruthbru
    ruthbru Member Posts: 47,698
    edited October 2017

    Runor, I loved your thoughts on the 'be positive' advice and am going to copy them down so I can share them when needed. I will only add that is also okay to be MAD. I was mad about the whole thing and resolved that cancer would NOT define me; to myself or to anyone else either.

    *adding, of course, that everyone handles things differently (a friend of mine who had been through treatment said keeping a journal had really helped her.......if I had kept a journal, it would have had one word written over and over....which would have been the word F**K), so whatever approach that gets you though this emotionally intact is the right course for you!

  • PauletteK
    PauletteK Member Posts: 1,279
    edited October 2017

    runor - well said!!! I love how you put it. Great encouragement. Will borrow few lines when I saw people down in here. I’m mad when people tell me be positive, how can I be positive? My MIL told me don’t think about it, how? I deal with se daily, going to have the dang infusion weekly!! People can make you mad.

    Actually today is my good day, I even slept six hours on my taxol infusion day I’m so happy.

    Ladies, have a great weekend!

  • ruthbru
    ruthbru Member Posts: 47,698
    edited October 2017

    People will say really stupid things. It helps if you:

    *develop a gallows-type sense of humor (or amusement anyway)

    *acknowledge that they mean well and are totally clueless

    * think back at times you offered people, what turned out to be, quite dreadful platitudes/advice yourself

    * resolve to go out of your way to do/say things that are actually helpful for/to others in the future


  • bravepoint
    bravepoint Member Posts: 232
    edited October 2017

    ruthbru - Thanks for that post! Great advice as always. I am trying to remember that people mean well and just smile and thank them for the good wishes. It can be tough though when they expect that this is something that I'll get better from like a bout with the flu!

  • TabzIsMyAngel
    TabzIsMyAngel Member Posts: 41
    edited October 2017

    Runor – Actually, I moved from MI to NY so I *would* have a support system. I was isolated in MI with no social life outside of work. After the break up, I couldn't afford a place of my own since my job was only part-time. So I moved back to my hometown where I have my Dad, a sister, and my aunt & cousin. And I count myself fortunate that the cancer center is only 5 minutes away so I don't have long drives to & from treatments & appointments. But at the same time, I am now in charge of my mother's affairs because she is in a nursing home, which is added stress.

    Perhaps "positive" isn't the right term. I think I meant more along the lines of hopeful, optimistic, determined to push forward. Plus, I'm a believer that you attract what you put out… so being positive/optimistic rather than negative/depressed draws & feeds more of the same. Maybe a part of it is that I really haven't yet allowed myself to completely let go, break down & have a good hard cry about the whole situation, because I'm afraid once I do I won't be able to stop & will end up sinking into a deep depression. But maybe it's something I need to do in order to prove to myself that I *AM* strong enough to pull myself back up by the bra straps & move on.

    Bravepoint – I live in Malone. So even a little further north – LOL. I actually was born & raised here, so am not unfamiliar with how harsh the winters can be (plus I spent 22 yrs in the mountains of NH before moving to MI 10 yrs ago) . But I've always hated winter & being cold. And once November comes, being cold is a permanent condition until at least April. My dad does have a treadmill at his place. I may ask if he or his wife don't use it during the winter if he could move it here to my place (I live alone in my mother's home since she's permanently in nursing home care).

    Thank you to every one for the support & warm wishes. I've been staying up way too late at night reading here, both the forums and the articles. Being informed about what I'm facing & going through is certainly something that's not lacking. LOL

    Oh, and as far as picking up my mail... my mailbox is just across the road from my driveway. So I plan on - at a very minimum - at least being able to accomplish that each day. Smile

  • PauletteK
    PauletteK Member Posts: 1,279
    edited October 2017

    Tabz - good to hear that you have supports, I spend my time on this website especially on the bad days that I can’t go out. How many rounds of AC are you doing and no radiation?

  • TabzIsMyAngel
    TabzIsMyAngel Member Posts: 41
    edited October 2017

    I'm doing 4 rounds of AC, 21 days between each, followed by 12 weeks of Paclitaxel & Herceptin, then continuing Herceptin to finish out a full 52 week course of treatment. I will be having radiation as well, but don't recall if my oncologist said it will be after or near the end of the full year of chemo.

    Tammy

  • Tpralph
    Tpralph Member Posts: 281
    edited October 2017

    So will be finished the chemo part of this journey on Thurs then alnd end of November. My mo also has ordered a CT to follow my small lung nodule which was seen incidentally from an abdominal CT for Diep in the summer. Guess it has to be followed for two years to make sure it is benign. Was 1 mm smaller 2 months after initial and before chemo. She thinks it is benign but gotta make sure. Bring on the scanxiety!

  • runor
    runor Member Posts: 1,615
    edited October 2017

    Tabz, good to hear you have support. I obviously had my wires crossed. I blame all my stupidty on tamoxifen!

  • mjsgumbas
    mjsgumbas Member Posts: 323
    edited October 2017

    Wow... I have been behind in my reading this summer. Welcome to the new ladies - sorry you have to join the "club". As always, good advice from some of the veteran women - they are the best!!

    I hope everyone is well and had an excellent summer. I have a question.... I met with my MO this week and have another appointment in 4 months (our normal schedule since DX). Apparently I will need to make a choice at the next appointment whether or not to stay on anastrazole (arimidex). When I was 1st DX, the recommendation was 10 years and now it seems they are reverting back to a 5 year recommendation. He was actually looking for me to give him an answer right there and then but I asked if we could discuss it at my next appointment, since I will be on until at least May.

    Hard to believe the 5 year mark is fast approaching - Nisa too!!! Just curious how long some of you have stayed on the meds or what your MO's have recommended?

    It's not an easy choice and it's awkward to have it be up to me - but I guess that's why they call it "practicing" medicine LOL. Not sure, how I feel about stopping but would love to be rid of some of the crappy side effects. Although there's no guarantee those will disappear either. I feel it's a catch 22 - stop and god forbid the monster returns....could've should've would've or stay on, feel crappy and the monster can still come back. I know no one can make the decision for me - I'm just curious as to what other's are experiencing.

    Side note... I became a Grandma in August... he is such a cutie!! Too young for this title, but loving it!!

    Heart

    Hugs to everyone!!!

  • ruthbru
    ruthbru Member Posts: 47,698
    edited October 2017

    MJS, I quit after 5 years. I was only slightly estrogen positive, so I felt that I had gotten as much good out of it as I could without possibly causing more 'collateral damage' from the side effects.

    ASCO has definitely backed away from it's 'everyone for 10 years' recommendations. At their meeting summer ago (I haven't seen anything from this summer's meeting yet) the research wasn't showing the results they thought they'd see. I am copying over a bunch of stuff from their Journal which you can wade through....or not......

    This is the latest research (that I know about) from ASCO (published December, 2016):

    Benefit of Extended Adjuvant Endocrine Therapy Not Upheld in Multiple Studies Reported in San Antonio

    Extended endocrine therapy with an aromatase inhibitor did not improve disease-free survival in patients with hormone receptor–positive breast cancer enrolled in three studies presented at the 2016 San Antonio Breast Cancer Symposium.

    The results stand in contrast to the phase III National Cancer Institute of Canada (NCIC) MA.17R study, which showed benefit for the extended use of adjuvant letrozole beyond 5 years.1 While some experts maintained that extended endocrine therapy remains important in subsets of patients, the results came as a surprise to many attendees, who said they may re-think their recommendations.

    John Cole, MD, a breast cancer specialist at Ochsner Medical Center in New Orleans, told The ASCO Post, "After MA.17R gave a positive signal for prolongation of aromatase inhibitor therapy, I think the expectation was that when these other studies came out, they would be supportive. In fact, none supported longer aromatase inhibitor therapy, and I think this was kind of shocking."

    He said that for many of his patients, extended treatment is "10 years of low-grade misery…. The important thing is that if your patient is really struggling, you don't have enough data now to make them endure another 5 years of treatment."

    He continued, "For my patients with stage I disease who I've been keeping on treatment, I'll stop. For my patients with heavier nodal burden who are tolerating the drugs, I will probably continue treatment."

    The studies' invited discussant at the San Antonio meeting, ­Michael Gnant, MD, Professor of Surgery at the Medical University of Vienna in Austria and President of the Austrian Breast & Colorectal Cancer Study Group, concluded that none of these trials achieved adequate statistical levels to show that the extension of aromatase inhibitor therapy was clearly beneficial. However, he suggested that treatment decisions in this setting need to be made on a patient-by-patient basis.

    Despite the success of adjuvant endocrine therapy in early breast cancer, approximately half of the recurrences occur after the first 5 years of treatment. Extending adjuvant endocrine therapy after 5 years of tamoxifen with either tamoxifen or an aromatase inhibitor improves disease-free survival in early-stage breast cancer, but the optimal duration of adjuvant aromatase inhibitor use beyond these 5 years has not been established. In MA.17R, women who took letrozole for a total of 10 years (beyond 5 years of tamoxifen or an aromatase inhibitor) had a 34% lower risk of breast cancer recurrence and contralateral breast cancers, though survival was similar.

    In contrast, the following findings were presented in San Antonio:

    In the NRG Oncology/National Surgical Adjuvant Breast and Bowel Project (NSABP) B-42 trial, 5 years of letrozole therapy after 5 years of endocrine treatment did not significantly improve disease-free survival or overall survival but did significantly improve the breast cancer–free interval event rate and distant recurrence rate.

    In the DATA study, 6 vs 3 additional years of anastrozole, after 2 to 3 years of adjuvant tamoxifen, did not improve rates of adapted disease-free survival.

    In the IDEAL trial, 5 vs 2.5 years of letrozole after 5 years of endocrine therapy failed to improve disease-free survival.

    The NRG Oncology/NSABP B-42 trial evaluated 5 years of letrozole (2.5 mg/d) vs placebo in 3,966 patients who had completed 5 years of hormonal therapy (aromatase inhibitor or tamoxifen followed by an aromatase inhibitor). Approximately one-third of patients were younger than 60 and almost half were node-positive. Overall, about 60% of both arms completed 5 years of additional treatment. The median follow-up for 3,923 patients included in the efficacy analysis was 6.9 years.

    The randomized, placebo-controlled study showed a small but not statistically significant improvement in disease-free survival (the primary endpoint) and no improvement in overall survival, although a significant improvement was seen in the breast cancer–free interval and distant recurrence, reported Eleftherios P. Mamounas, MD, of the NSABP, now part of NRG Oncology. Dr. Mamounas is also Medical Director of the Comprehensive Breast Program at the University of Florida Health Cancer Center and Orlando Health.

    Disease-free survival at approximately 7 years was 84.7% with extended letrozole vs 81.3% with placebo (hazard ratio [HR] = 0.85, P = .048). Overall survival was 91.8% with letrozole and 92.3% with placebo (HR = 1.15, P = .22).

    "For the primary endpoint, we saw a 15% reduction in risk. You may think this looks statistically significant, but the level for statistical significance was set at P = .0418 (because of adjustments for four interim analyses), so technically this is not significant," Dr. Mamounas reported.

    Three studies presented at the 2016 San Antonio Breast Cancer Symposium evaluating extended use of aromatase inhibitors in hormone receptor–positive postmenopausal patients failed to meet their primary endpoints.

    Disease-free survival was not improved by the addition of 5 years of extended aromatase inhibitors after therapy with tamoxifen or an aromatase inhibitor.

    NRG Oncology/NSABP B-42 evaluated 5 years of letrozole vs placebo in 3,966 patients, and the study showed a 15% (nonsignificant) reduction in risk.

    Disease-free survival at 7 years was 84.7% with extended letrozole vs 81.3% with placebo (hazard ratio [HR] = 0.85, P = .048 [not significant]).

    There were, however, significant improvements in distant metastases, contralateral breast cancer, and breast cancer–free interval events in B-42.

    The European DATA and IDEAL studies also failed to show benefits for extended endocrine therapy.

    "We did see a major difference in the reduction of distant recurrence, however, and also in breast cancer–free interval events (which includes recurrences of breast cancer and cancers in the opposite breast), with extended letrozole," he added, citing the following benefits for extended therapy:

    breast cancer–free interval events: 6.7% vs 10.0% (HR = 0.71, P = .003); distant recurrence: 3.9% vs 5.8% (HR = 0.72, P = .03)

    There was no significant difference in the incidence of osteoporotic fractures (5.4% vs 4.8%; HR = 1.19, P = .27) and occurrence of thrombotic events (4.0% vs 3.4%; HR = 1.21, P = .29), though a slight increase in thrombotic events occurred after 2.5 years of letrozole therapy.

    Dr. Mamounas pointed out, however, that the results, while not statistically significant, would not be that different from those of MA.17R if the primary endpoint were defined the same. In B-42, disease-free survival included recurrence, contralateral breast cancer, nonbreast cancers, and deaths as first events. In MA.17R, disease-free survival included only recurrence and contralateral breast cancers. When disease-free survival in MA.17R was defined by adding deaths from any cause to recurrence and contralateral breast cancer, its hazard ratio was 0.80 (P = .06), similar to the 0.85 in B-42 (P = .048), he pointed out.

    "Our findings suggest that careful assessment of potential risks and benefits, such as patient and tumor characteristics, comorbidities, information on bone mineral density, and tolerance of the initial 5 years of the aromatase inhibitor, is required before recommending extended aromatase inhibitor therapy," Dr. Mamounas concluded.

    The phase III DATA study randomly assigned 1,912 postmenopausal women who had received 2 to 3 years of adjuvant tamoxifen to either 3 or 6 years of anastrozole. Results of the study were reported by Vivianne Tjan-Heijnen, MD, PhD, of Maastricht University Medical Centre, Netherlands.

    The primary endpoint was adapted disease-free survival, defined as disease-free survival beyond 3 years after randomization to aromatase inhibitor therapy (initially, all patients received the same aromatase inhibitor for 3 years). This included breast cancer recurrences, second primary breast cancers, and death from any cause.

    The study was designed to detect an increase in the adapted disease-free survival for 6 years of anastrozole vs 3 years corresponding with a hazard ratio of 0.60. Instead, the hazard ratio was 0.79 (P = .07). Five-year adapted disease-free survival was 83.1% for patients receiving 6 additional years of anastrozole and 79.4% for those receiving 3 years, Dr. Tjan-Heijnen reported.

    Erik Blok, MD, of Leiden University Medical Center, presented the results of the randomized phase III IDEAL trial, which compared a total of 7.5 years vs 10 years of endocrine therapy. Patients had received 5 years of adjuvant tamoxifen (10%), aromatase inhibitor (30%), or tamoxifen followed by an aromatase inhibitor (60%). The 1,824 patients were randomized to letrozole for 2.5 years or 5 more years of extended therapy. Also, this trial was designed to detect a hazard ratio of 0.6 in disease-free survival after the treatment arms diverged.

    The 5-year disease-free survival rate was 88.4% in patients receiving 2.5 more years of treatment and 87.9% for those receiving 5 additional years (HR = .96, P = .70). Overall survival rates were 93.5% and 92.6%, respectively (HR = 1.08, P = .59). There was a significant difference in the prevention of second primary breast cancers (HR = 0.37, P = .008), but this represented a small (1%) absolute risk reduction. ■

  • Tpralph
    Tpralph Member Posts: 281
    edited October 2017

    Thanks for sharing this Ruth! I just finished chemo and will start tamoxifen in 4 weeks for 2-3 years then an al inhibitor. It will be interesting to see if there are any more changes in 5 years

  • jbdayton
    jbdayton Member Posts: 163
    edited October 2017

    My MO appointment is this coming Tuesday. My last appointment he mentioned changing to 5 years but we would discuss this in more detail as I approach year 5. I will be at 4 completed years in a few weeks. I began AI therapy the third week of November 2013.

    I luckily have very minor SE's. I have no hot flashes, minor joint pain on Accord brand but have been on TEVA the past 3 months and notice no joint pain. My new script just arrived and the new pills came in as Accord as the manufacturer again. ( I am going to try them but if the joint pain returns I will have to see if there is anyway to get TEVA again). My Vit D is normal and my bone density is excellent for my age. I have not gained any weight but can't lose either. I would like to be at least 15 lbs lighter.

    This will be a difficult decision to continue or not to continue with my favorable experience. I will update after myappointment.

  • mjsgumbas
    mjsgumbas Member Posts: 323
    edited October 2017

    Thank you Ruth! Was it hard for you personally to stop the meds? Just curious. That pretty much sums up what my MO said, they don’t see any true benefits from staying on longer than 5 years. I was a little surprised, since it was 10 years, but I guess they’ve learned some in the last 5 years. Part of me hopes by getting off, the traveling bone pains and the mess it’s made of my joints will get better in time...but I’m not getting any younger either 😂

    Thanks again!! You are always quick to help!! Really appreciate it!!

  • ruthbru
    ruthbru Member Posts: 47,698
    edited October 2017

    When I first started on it, I was of the mindset that I wanted to stay on it forever. My oncologist and I talked about it a lot. If I had insisted, I think I could have talked him into seven years, but he said he would absolutely NOT recommend it for more than that (with my stats anyway). As I got closer to 5 years; I decided that since studies were saying it would not actually help (with my statistics anyway), and since my estrogen would be decreased naturally (since I was 5 years older), and since I wanted to protect my overall health......I quit. It was very scary but very liberating as well. I never had horrible SEs while on, but definitely just feel 'lighter' (hard to explain) since I've been done.

    * I do want to point out that I'm just sharing my experience, not advocating that anyone do the same. Those decisions need to be made in consultation with your oncologist and with your own personal risk factors, age, other health concerns, feelings etc. etc. No easy decisions, for sure.

    Tpralph, they will probably change their recommendations FIVE times in the next five years......drives me crazy!